Women's Occupational Patterns and Later Life Physical Functioning.

Timing and accumulation of work-related exposures may influence later life health. This study evaluates the association between women's work patterns and physical functioning. Work history and physical functioning information was collected at baseline for U.

Contact tracing for the control of infectious disease epidemics: Chronic Wasting Disease in deer farms.

Contact tracing is a crucial component of the control of many infectious diseases, but is an arduous and time consuming process. Procedures that increase the efficiency of contact tracing increase the chance that effective controls can be implemented sooner and thus reduce the magnitude of the epidemic. We illustrate a procedure using Graph Theory in the context of infectious disease epidemics of farmed animals in which the epidemics are driven mainly by the shipment of animals between farms.

Work Characteristics Associated with Physical Functioning in Women.

Women make up almost half of the labor force with older women becoming a growing segment of the population. Work characteristics influence physical functioning and women are at particular risk for physical limitations. However, little research has explored the effects of work characteristics on women's physical functioning.

Parents' Concerns as They Relate to Their Child's Development and Later Diagnosis of Autism Spectrum Disorder.

Objective: Data from a toddler screening study were used to examine: (1) categories of concerns regarding the development of their child reported by parents prior to diagnostic evaluation, (2) congruence of parent concerns with their child's later diagnosis, (3) the extent to which parent concern(s) were associated with the therapies their child received and types of specialists consulted, and (4) the association between the number of parental concern categories and clinical measures.

Method: Toddlers who screened positive for autism spectrum disorder (ASD) during well-child checkups received a diagnostic evaluation and parents completed a history questionnaire (n = 532; 274 ASD, 258 non-ASD). Parents' concerns about their child's development, therapy received, and specialists consulted were coded into discrete categories.

Total blood mercury levels and depression among adults in the United States: National Health and Nutrition Examination Survey 2005-2008.

Background: Mercury is a neurotoxicant linked with psychiatric symptoms at high levels of exposure. However, it is unclear whether an association is present at the low exposure levels in the US adult population.

Materials And Methods: Cross-sectional associations of total blood mercury and depression were assessed in 6,911 adults age ≥20 in the National Health and Nutrition Examination Survey (NHANES), 2005-2008.

Walking Ability and Its Relationship to Self-Rated Health in Later Life.

This study investigated the relationship between self-assessed overall health (SRH) and walking ability among older adults (n = 239) gauged using three well-established measures of walking ability ("normal" and "fast" walking speeds, and perceived walking difficulty). Logistic regression models adjusted for health, behavioral, and sociodemographic variables were used to estimate the relationship between the three measures of walking ability and SRH. Walking ability was significantly associated with SRH; notably, only normal walking speed discriminated between participants in all three SRH comparisons (good versus poor/bad, good versus fair, or excellent versus good).

Defining racial and ethnic disparities in pain management.

Background: Substantial pain prevalence is as high as 40% in community populations. There is consistent evidence that racial/ethnic minority individuals are overrepresented among those who experience such pain and whose pain management is inadequate.

Questions/purposes: The objectives of this paper are to (1) define parameters of and summarize evidence pertinent to racial/ethnic minority disparities in pain management, (2) identify factors contributing to observed disparities, and (3) identify strategies to minimize the disparities.

Post-traumatic stress disorder, drug abuse and migraine: new findings from the National Comorbidity Survey Replication (NCS-R).

Background: Post-traumatic stress disorder (PTSD) has been shown to be associated with migraine and drug abuse.

Methods: This was an analysis of data from the National Comorbidity Survey Replication (NCS-R) to evaluate the association of PTSD in those with episodic migraine (EM) and chronic daily headache (CDH).

Results: Our sample consisted of 5,692 participants.

Congenital anomalies and resource utilization in neonates infected with herpes simplex virus.

Background: Neonatal herpes simplex virus (HSV) infection, while uncommon, is associated with substantial morbidity and mortality. However, there is little nationally representative data describing resource utilization.

Methods: This retrospective cohort study was conducted using the Pediatric Health Information System, an administrative database that contains discharge diagnosis and resource utilization data from 35 free-standing children's hospitals.

Caffeine: neuroprotective functions in cognition and Alzheimer's disease.

Alzheimer's disease is a common problem in our elderly population. Although research is leading to improvements in our understanding of the underlying biology, we still have little understanding of the environmental risk factors associated with this disorder. Caffeine, an easily modifiable environmental factor, may have a protective effect on the likelihood of developing Alzheimer's disease.

Depression and self-rated health are proximal predictors of episodes of sustained change in pain in independently living, community dwelling elders.

Objective: To identify, in community dwelling elders, the determinants of sustained pain improvement or worsening.

Design: A longitudinal study with two baseline and 11 monthly follow-up interviews was conducted. Pain was assessed monthly using the Parmelee adaptation of the McGill Pain Inventory.

Changes over 4 years in health, quality of life, mental health, and valuation of life.

Objective: This longitudinal study explores how the relationship between changes in physical health and changes in valuation of life (VOL) may be affected by changes in quality of life and in mental health.

Method: 335 community residents older than age 70 were interviewed over a 4-year period. Analysis used correlation and regression models.

Preliminary evaluation of the Health Background Questionnaire for Pain and clinical encounter form for pain.

Objectives: The principal aims of this study were to evaluate the extent to which patients completed, understood, and were satisfied with the Health Background Questionnaire for Pain (HBQ-P), a health and pain history questionnaire that includes a modification of the Medical Outcome Study Short Form-36, the Treatment Outcomes in Pain Survey, and to examine the degree to which the questionnaire produced reliable and valid responses. A secondary aim was to determine the length of time for a physician to complete the Clinician Evaluation Form for Pain (CEF-P), a brief questionnaire designed to obtain key elements resulting from clinical assessment and management decisions.

Methods: This cross-sectional study utilized data from consecutive new patients seen from January to December 2001 in Drexel University College of Medicine's Pain Medicine and Comprehensive Rehabilitation Center at Graduate Hospital in Philadelphia, PA.

The longitudinal occurrence and impact of comorbid chronic pain and chronic depression over two years in continuing care retirement community residents.

Objective: To describe the longitudinal course of depressive symptoms and pain experienced by continuing care retirement community (CCRC) residents and to investigate the impact of comorbid chronic activity-limiting pain and chronic high depressive symptoms on physical functioning and health service use.

Methods: This longitudinal study of 169 CCRC residents involved five assessments (baseline and four in-person interviews at 6-month intervals). The Geriatric Depression Scale (GDS), questions drawn from the McGill Pain Questionnaire, and self-report data on physical functioning and health care use were assessed.

The effects of pain and depression on physical functioning in elderly residents of a continuing care retirement community.

Unlabelled: OBJECTIVE. Explore the relationships between pain, depression, and functional disability in elderly persons.

Design: A cross-sectional, observational study of 228 independently living retirement community residents.

Validating the diagnosis of delirium and evaluating its association with deterioration over a one-year period.

The authors probed the associations between clinical diagnoses and independent research measures of cognitive, behavioral, and electroencephalographic (EEG) changes in hospitalized older patients and investigated the contribution of medical illness to deterioration. Patients (N=96; 47 of whom were hospitalized during the course of 1 year; 12 diagnosed with delirium) received tests of cognitive and physical functioning and the Cumulative Illness Rating Scale, specific neuropsychological tests, and a two-channel EEG. Delirium was associated with independent measures of cognitive decline and EEG slowing.

Survival of hospitalized elderly patients with delirium: a prospective study.

The authors tested the relationship between clinically diagnosed delirium during hospitalization and increased mortality after accounting for pre-hospital measures of global cognition, physical functioning, and medical comorbidity. Patients (N=102), 53 of which were hospitalized during the course of a year, received the Mini-Mental State Exam, Physical Self-Maintenance Scale, Cumulative Illness Rating Scale, and 15-item Geriatric Depression Scale. Mortality rates were determined at discharge and after 3 years.

Chronic pain. Sources of late-life pain and risk factors for disability.

The prevalence of pain peaks in middle age and decreases thereafter, according to most epidemiologic studies of complaints of pain. However, this apparent decrease in pain in older adults may be a statistical artifact. Eighty to 85% of persons experience a significant health problem that predisposes them to pain at some time after age 65.

Diagnosis and treatment of depression in late life. Consensus statement update.

Objective: To reexamine the conclusions of the 1991 National Institutes of Health Consensus Panel on Diagnosis and Treatment of Depression in Late Life in light of current scientific evidence.

Participants: Participants included National Institutes of Health staff and experts drawn from the Planning Committee and presenters of the 1991 Consensus Development Conference.

Evidence: Participants summarized relevant data from the world scientific literature on the original questions posed for the conference.

Occult liver abscess following clinically unsuspected ingestion of foreign bodies.

Two uncommon cases of foreign body (a wooden clothespin and a toothpick) perforation of the gur with associated pyogenic liver abscesses are presented. These cases illustrate the difficulties of preoperative diagnosis. The lack of history of ingestion of foreign bodies, variable clinical presentation of the conditions and radiolucent natures of the foreign bodies all play a role in impeding the diagnosis preoperatively.

Effectiveness of a psychosocial intervention, interpersonal counseling, for subdysthymic depression in medically ill elderly.

Background: Subdysthymic depression occurs in 20-50% of hospitalized elderly and is associated with physical and social disability, delayed recovery, and excess health service use. Despite this, little is known regarding the nature of such depressive symptomatology, or its responsivity to treatment. To address this, a randomized clinical trial assessing the feasibility and efficacy of Interpersonal Counseling (IPC), a short-term psychotherapy, was conducted.

Does treatment of asymptomatic bacteriuria in older ambulatory women reduce subsequent symptoms of urinary tract infection?

Objective: To determine whether treatment of symptomatic bacteriuria in older ambulatory women affects the subsequent development of symptoms of urinary tract infection.

Design: A controlled clinical trial.

Participants: Older women not having urinary catheters.

Social support, depression, and recovery of walking ability following hip fracture surgery.

The importance of social support and depression to recovery from illness is examined with reference to hip fracture. Subjects were community-dwelling, ambulatory White females 59 years of age and over who were recovering from hip fracture surgery. The respondents were interviewed at baseline and clinically interviewed 2 and 6 months postsurgery.

Esophagotomy for incarcerated esophageal foreign bodies.

Less than 1% of esophageal foreign bodies are irretrievable by endoscopic techniques. Incarcerated esophageal foreign bodies require esophagotomy for removal. A retrospective study was conducted to determine the incidence, predisposing factors, and optimal treatment of incarcerated esophageal foreign bodies.